Add these seven exercises to your strength plan to avoid Achilles pain

No running injury is good news, but Akhilova’s injury could be particularly painful. It usually feels like a sharp pain shooting through the back of the ankle every time you push off the ground with that foot. And unfortunately, Achilles injuries can be really hard to shake.

In fact, dealing with Achilles tendinopathy, which affects one in 20 recreational runners at least once in the past year, is the biggest risk factor for the injury, according to a 2020 study published in Journal of Science and Medicine in Sports.

Here’s more about the types of Achilles pain you can experience, what makes certain runners more prone to these injuries, and some exercises to help strengthen the tendon and the surrounding area so you’re not sidelined.

The different types of Achilles injuries

The most common Achilles injury runners experience is Achilles tendinitis, which refers to an acute tendon injury that involves inflammation and microtears around the tendon, says Ann Bui, DPT, CSCS, a former collegiate runner, physical therapist, and biomechanics specialist in Oakland, California.

Acute means that the pain is usually fairly short-lived (ie, lasting less than three months). You may feel the pain in the middle of the tendon or at the insertion point, which is at the back of the heel where the Achilles bone attaches to the heel bone (calcaneus), she explains.

Achilles tendinopathy (sometimes used as a catch-all term for tendon problems) usually involves a gradual onset of pain and stiffness around the Achilles. Tendinopathy tends to refer to more chronic, nagging pain, Bui says.

And then comes the Achilles rupture, which is much more severe. This is when tears in the tendon eventually cause a partial or complete break, says Adefemi Betiku, DPT, CSCS, a physical therapist in New Jersey. It feels like a popping sensation on the back of your heel or calf and is extremely painful.

This injury is less common, but the incidence is increasing. Almost 82 percent of all Achilles ruptures occur in people participating in sports or recreational activity; Basketball is by far the most common, but running (along with hiking and stretching) accounts for 5.8 percent of ruptures, according to a recent Brown University study.

What does an Achilles injury feel like?

Aside from that audible pop or popping associated with a rupture, there’s a good chance you’ll experience pain in the back of your ankle with Achilles tendonitis or tendinopathy, especially when you’re on your toes or pushing off the ground while running. But pain doesn’t always present in the same way and can vary in severity, says Hamish Vickerman, a physiotherapist based in Australia.

Morning stiffness in the tendon is a common sign of Achilles problems, especially tendinopathy, he says. In milder cases, some people may experience an initial improvement or reduction in pain with activity or movement as the tendon warms up, which is known as the warm-up effect.

You may also notice swelling or redness in the area, but not always, and the area will also likely be tender to the touch.

Common causes of Achilles injury

Rapidly increasing mileage is a common cause of Achilles pain, as is aggressively increasing your intensity, that is, adding too many fast intervals or too many hills too soon, notes Vickerman.

Runners with a forefoot strike tend to put more stress on their calves and Achilles and can be more prone to injury, Bui says. Same with those who lack range of motion or toe extension on ankle dorsiflexion. You may not realize it, but you can compensate for this by increasing the strain on the soft tissue structures around the ankle joint, such as the Achilles, she says.

Inadequate strength in any or all of your lower leg muscles (read: your gastrocnemius and soleus, peroneals, tibialis posterior, and tibialis anterior) can also increase your risk. These contributing factors along with low hip abduction and knee extension strength were seen more in runners with Achilles tendinopathy compared to a control group, according to research published in the journal. Physical therapy in sports.

Men and older runners have a higher incidence of Achilles injuries, especially tendinopathy. And if you have a history of other injuries in the area, including plantar fasciitis, patellar tendonitis, or a fracture somewhere in your lower extremities, the risk also increases, Beticu notes. The same if you often run in cold weather and if you have used medical steroids for a long period of time.

7 moves to prevent Achilles injuries

Fortunately, there are some easy, equipment-free exercises you can add to your routine to gradually increase the load on your Achilles tendons and help prepare you for injury-free running.

To proactively negate the risk of Achilles problems, emphasis should be placed on maintaining the load-bearing capacity of the Achilles, says Vickerman. This can be achieved through a consistent regimen of strengthening the calf complex, incorporating heavy, slow resistance training and plyometric exercises, all aimed at improving tendon health and optimizing tendon energy storage and release.

Here are seven exercises you should try:

1. Calf Raise Pose

achilles routines

Trevor Raab

  1. Stand with your heels off the edge of a step, then lift your heels. Hold for 45 seconds.
  2. Reduce and rest for 2 minutes.
  3. Repeat. Do 5 repetitions. Work up to a single leg calf raise position.

2. Lifting of eversion

achilles routines

Trevor Raab

  1. Stand with heels close together, toes pointed.
  2. Slowly lift your heels up.
  3. Slowly lower your heels down.
  4. Repeat. Do 2 sets of 10 repetitions.

3. Lifting inversion

achilles routines

Trevor Raab

  1. Stand with your toes close together, heels turned out.
  2. Slowly lift your heels up.
  3. Slowly lower your heels down.
  4. Repeat. Do 2 sets of 10 repetitions.

    4. One calf drop

    achilles routines

    Trevor Raab

    1. Stand with your heels off the edge of a step.
    2. Raise your heels, then stand on the affected foot and slowly lower that heel off the edge of the step.
    3. Repeat. Do 3 sets of 15 repetitions.

    5. Step Stretching

    achilles routines

    Trevor Raab

    1. Stand with your heels on the edge of a step. Slowly lower your heels to feel the stretch along the back of your ankle and calf. Hold for 30 seconds.
    2. Rest, then repeat twice.

    6. Box Jump

    achilles routines

    Trevor Raab

    1. Stand with your feet hip-width apart in front of a box at least 12 inches high.
    2. Lower into a half squat, then jump onto the box.
    3. Get down.
    4. Repeat. Do 3 sets of 6-8 reps.

    7. Drop Jump

    achilles routines

    Trevor Raab

    1. Stand with your feet hip-width apart on a box.
    2. Step off the edge and land on the floor in front of the box with both feet, keeping your weight evenly distributed from toes to heel.
    3. Immediately jump straight up with your feet together.
    4. Go back to the box.
    5. Repeat. Do 3 sets of 6-8 reps.

    What to do if you have Achilles pain

    First things first: take some time. Getting at least a few days of R&R (by way of complete rest or cross-training, plus ice cream and gentle calf stretches) at the first signs of soreness in your Achilles can go a long way when dealing with the initial painful phase, Bui says.

    But after those few days of recovery, get back to activity. Tendons need progressive loading over time to heal, Bui explains. Resting a tendon for weeks or months usually does not promote healing.

    For any ongoing tendinopathy (aka, pain that lasts more than three months), Betiku advises talking to a doctor or physical therapist. They can help you figure out the best plan to get you back up and running while eliminating pain rather than risking re-injury.

    Head shot by Laurel Leicht

    Laurel Leicht is a writer and editor in Brooklyn. She covers health, fitness and travel for outlets including Well+Good, Glamor and O, The Oprah Magazine.

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